Andhra Bank School of Business Building, Andhra University Campus, Visakhapatnam – 530 003

Andhra Pradesh, INDIA. Tel: +91 891 2824 444 | e-mail:

Application for Non-teaching StaffPositions

Instructions:

  1. Please use the format given below only and provide complete data.
  2. At this stage of application, please DO NOT attach/submit copies of any certificates. Such proof would be sought ONLY from short-listed applicants.
  3. Only typed applications will be accepted.
  4. Please refer to the notification on IIM Visakhapatnam website for Job Code and Title

Job Code: _____

Job Title: ______

Category: General/SC/ST/OBC/PwD (Please tick appropriately)

  1. Name (in capital letters, with surname/last name in the end)
  1. Date of Birth (dd/mm/yyyy) :
/ Space for Passport size Photograph
3.Address and Contact Details
CommunicationAddress: / Permanent Address:
Pincode: / Pincode:
Phone No. (Landline):
Phone No. (Mobile): / Phone No. (Landline):
Phone No. (Mobile):
E-mail:

4. Education Details:

Exam / Qualification Title / Subjects / Specialization (if any) / Institution/University / Mode of Study
(Fulltime/
Part time) / Year of Passing / Overall Marks/
Percentage/CGPA
X Std.
10+2/Intermediate
Diploma
Graduation
Post-Graduation
Post-Graduate Diploma
Others (Please specify)

Please add additional rows if required

5. Work Experience Details (List in reverse chronological order)

Name and address of the Employer / Period / Duration / Employment Type
(Regular / Contractual) / Designation / Last drawn Salary (CTC Per annum) in Rs / Key Responsibiliities
From
mm/yy / To
mm/yy / Years / Months

Please add additional rows/sheets if required

Total Experience in Officer Grade / Level: ____ Years; ____Months

Total Experience in Non-Officer Grade / Level: ____ Years; ____Months

6. Proficiency in Languages (other than English) : Please Write Yes / No

Language / Read / Write / Speak
Telugu
Hindi
Others (please specify)

7. Professional References (Not relatives) of three persons:

a. <Name, Designation, Organization, E-mail ID, Mobile No.>

b. <Name, Designation, Organization, E-mail ID, Mobile No.>

c. <Name, Designation, Organization, E-mail ID, Mobile No.>

8. Statement of Purpose: Please describe in about 800 words, why you wish to join IIM Visakhapatnam and how your qualifications & experience would be useful to the Institute in the post you are applying for.

9. Any other information you may wish to add/highlight:

10. Declaration:

I hereby declare that all the statements/particulars made/furnished in this application are true, complete and correct to the best of my knowledge and belief. I also fully understand that in the event of any information furnished being found false, incomplete or incorrect at any stage, my application/candidature is liable to be summarily rejected and if I am already appointed, my services are liable to be terminated from the post, without any notice and without prejudice to any other legal/penal action that the Institute may initiate, as deemed fit.

______

Date : Signature of the applicant

Place: Name of the applicant: ______

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